Attention to affective pictures and emotional arousal between naturally cycling women, oral contraceptive users and men: Evidence from eye tracking and pupillometry.

Oral contraceptive (OC) use has been linked to altered emotional reactivity compared to the natural menstrual cycle. However, little is known about how emotional arousal and attention to emotional content relate to this association. This study investigated emotional attention and arousal during an emotional perception task among naturally cycling (NC) women, OC-users, and men. NC women in their follicular phase (n = 36), OC-users (n = 33), and men (n = 38) viewed erotic, neutral, and negative pictures while their eye movements and pupil sizes were recorded. The Generalised Anxiety Disorder questionnaire assessed anxiety. A Visual Analog Scale was used to measure arousal and valence ratings after each picture, and the level of emotional arousal throughout the task. Saliva samples were collected to determine the levels of progesterone and testosterone. Results indicated that OC-users were more anxious, felt more emotionally aroused, and tended to rate erotic and negative pictures more negatively than men, but did not differ significantly from NC women. During the presentation of erotic and neutral pictures, faces attracted more attention (longer dwell time and higher return probability) from NC women than from OC-users and men. Women exhibited smaller amplitudes of light reflex and larger pupil diameters in later response phases than men, with no significant differences between NC women and OC-users. Although OC use was not associated with overall attention to affective pictures, OC-users showed lower attention to faces than NC women. These findings offer insights into how OC use might be related to emotional processing.